Reliability, validity, sensitivity and internal consistency of the ICF based Basic Mobility Scale for measuring the mobility of patients with musculoskeletal problems in the acute hospital setting: a prospective study

Abstract

BackgroundThe assessment of mobility is important in the acute care setting. Existing tests suffer from limitations. The aim of the study was to examine the inter-rater reliability, the validity, the sensitivity to change, and the internal consistency of an ICF based scale.MethodsIn a prospective study inpatients in the acute care setting with restricted mobility aged above 50 years assigned to rehabilitative treatment were included. Assessment of subscales of the Functional Independence Measure (FIM) and the ICF based Basic Mobility Scale (BMS) were performed at admission and before discharge. Furthermore pain, length of stay in hospital, and post-discharge residential status were recorded. Inter-rater reliability, criterion-concurrent validity, sensitivity to change, and internal consistency were calculated. Furthermore, floor and ceiling effects were determined.ResultsOne hundred twenty-five patients (79 women/46 men) were included. The BMS showed an excellent inter-rater reliability for the total BMS (ICC BMS: 0.85 (95 % CI: 0.81–0.88). The criterion-concurrent validity was high to excellent (Spearman correlation coefficient: −0.91 in correlation to FIM) and the internal consistency was good (Cronbach’s alpha 0.88). The BMS proved to be sensitive to improvements in mobility (Wilcoxon’s signed rank test: p < 0.0001; The effect size for the BMS was 1.075 and the standardized response mean 1.10. At admission, the BMS was less vulnerable to floor effects.ConclusionsThe BMS may be used as a reliable and valid tool for the assessment of mobility in the acute care setting. It is easy to apply, sensitive to change during the hospital stay and not vulnerable to floor and ceiling effects.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0638-7) contains supplementary material, which is available to authorized users.

Effect of Early Mobilization on Respiratory and Limb Muscle Strength and Functionality of Nonintubated Patients in Critical Care: A Feasibility Trial

“…Among the functional scales used in this study, ICF-BMS detected the highest percentage of participants who reached this clinically important threshold (72.5%) for which a 7point variation was considered [21]. FSS-ICU is considered feasible to perform in an ICU and had an MCID estimated interval of 3 points [33], which was reached by 15 (37.5%) patients from our study.…”

“…e large effect sizes for the functionality outcome reaffirm the importance of following an exercise protocol for this population, especially when we assess them by the ICF-BMS scale involving mobility activities, for instance, getting in/out of their bed to climbing stairs, and that the improvement level was 72.5% by reaching MCID, while 52.5% of the patients had the floor effect at ICU discharge. is did not occur in the study by Pieber et al [21], where the interrater reliability, validity, sensitivity to change, and internal consistency of the same scale were evaluated and showed that it was not vulnerable to floor-ceiling effect.…”

“…e evaluators were previously trained and instructed on the application of the scales and followed the recommendations of instrument methods and clinical trials of the Core Outcome Measures in Effectiveness Trials (COMET) initiative project [19], which promotes the creation of measuring standards for clinical trials. e functionality assessment tools used were the Functional Independence Measure (FIM), [20] the Functional Status Score for the Intensive Care Unit (FSS-ICU) [5], the International Classification of Functioning, Disability and Health-Based Basic Mobility Scale (ICF-BMS) [21], and the scored Physical Function Intensive Care Test (PFIT-s) [22]. Only FIM and FSS-ICU are validated for the Brazilian population [23,24] by the time the study was conducted and ICF-BMS and PFIT-s have already been in use internationally to assess the functionality of people confined to ICU environment [25].…”

Validity and reliability instruments m-health nursing as a mobility elderly detection tool

“…According to Fukunaga, Saitou, Harada, Hakamata, & Kagawa, (2015) stated that the mobility measurement instrument has an ICC value higher than 0.8 so it can be recommended to be used to measure the status of elderly mobility by testing on various units or research sites. Pieber, Herceg, Paternostro-Sluga, (2015) stated that the measuring instrument used to measure the mobility status of the elderly that is based on the International Classification of Functioning, Disability and Health useful and reliable measuring instrument with a valid ICC value of 0.85 (95% CI: 0.81-0.88). Studies conducted by Park, (2017) showed that the intraclass correlation used in the Timed Up and Go Test measuring instrument has a value higher than 0.90 so that the instrument can be used as a reference in the preparation of another mobility measurement instrument.…”

Construct validity and inter-rater reliability of the Dutch activity measure for post-acute care “6-clicks” basic mobility form to assess the mobility of hospitalized patients

“…So far, various measurement tools have been developed to assess and monitor the independent mobility of hospitalized patients [13][14][15][16][17][18][19], but it appears that the majority of physiotherapists working in hospitals currently do not use these tools as a standard part of their care [20]. Underlying reasons for not adopting the available instruments are that they are too time consuming to complete during usual care, too time-consuming to analyze or they have been designed for only a small part of the total hospital population [20].…”